LIVER BIOPSY - INDICATIONS, PROCEDURES, RESULTS Edited by Nobumi Tagaya Liver Biopsy - Indications, Procedures, Results http://dx.doi.org/10.5772/46113 Edited by Nobumi Tagaya Contributors Firpi, Alpna Limaye, Lisa Dixon, Ludmila Viksna, Ilze Strumfa, Janis Vilmanis, Andrejs Vanags, Zane Simtniece, Dzeina Sulte, Arnis Abolins, Janis Gardovskis, Ervins Vasko, Javier Crespo, Joaquín Cabezas, Marta Mayorga, Hiroyasu Morikawa, Jean-François Cadranel, Jean-Baptiste Nousbaum, Ivan Tokin, Anna Mania, Pawel Kemnitz, Magdalena Figlerowicz, Wojciech Sluzewski, Aldona Woźniak, Nobumi Tagaya, Nana Makino, Masatoshi Oya, Yoshitake Sugamata, Claudia Randazzo, Anna Licata, Piero Luigi Almasio, Teresa Casanovas, Costin Teodor Teodor Streba, Letitia Adela Maria Streba, Daniela Dumitrescu, Eugen Florin Georgescu, Monica Lupsor, Horia Stefanescu, Diana Feier, Radu Ion Badea Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. 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Publishing Process Manager Viktorija Zgela Technical Editor InTech DTP team Cover InTech Design team First published November, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Liver Biopsy - Indications, Procedures, Results, Edited by Nobumi Tagaya p. cm. ISBN 978-953-51-0853-5 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface VII Section 1 An Overview and Future Aspects of Liver Biopsy 1 Chapter 1 Liver Biopsy - Indications, Procedures, Results 3 Claudia Randazzo, Anna Licata and Piero Luigi Almasio Chapter 2 Types of Liver Biopsy 23 Nobumi Tagaya, Nana Makino, Kazuyuki Saito, Takashi Okuyama, Yoshitake Sugamata and Masatoshi Oya Chapter 3 Rethinking the Role of Liver Biopsy in the Era of Personalized Medicine 33 Teresa Casanovas Taltavull Section 2 Clinical Practice of Liver Biopsy 73 Chapter 4 Safety and Reliability Percutaneous Liver Biopsy Procedure in Children with Chronic Liver Diseases 75 Anna Mania, Paweł Kemnitz, Magdalena Figlerowicz, Aldona Woźniak and Wojciech Służewski Chapter 5 Risks and Benefits of Liver Biopsy in Focal Liver Disease 85 Letiția Adela Maria Streba, Eugen Florin Georgescu and Costin Teodor Streba Chapter 6 Current Trends in Liver Biopsy Indications for Chronic Liver Diseases 103 Jean-François Cadranel and Jean-Baptiste Nousbaum Chapter 7 Primary and Metastatic Tumours of the Liver: Expanding Scope of Morphological and Immunohistochemical Details in the Biopsy 115 Ilze Strumfa, Janis Vilmanis, Andrejs Vanags, Ervins Vasko, Dzeina Sulte, Zane Simtniece, Arnis Abolins and Janis Gardovskis Chapter 8 Nonalcoholic Fatty Liver Disease: A Pathological View 161 Joaquín Cabezas, Marta Mayorga and Javier Crespo Chapter 9 Liver Biopsy After Liver Transplantation 189 Alpna R. Limaye, Lisa R. Dixon and Roberto J. Firpi Section 3 Non-Invasive Alternatives of Liver Biopsy 207 Chapter 10 Non-Invasive Evaluation of Liver Steatosis, Fibrosis and Cirrhosis in Hepatitis C Virus Infected Patients Using Unidimensional Transient Elastography (Fibroscan®) 209 Monica Lupsor, Horia Stefanescu, Diana Feier and Radu Badea Chapter 11 Computer Image Analysis of Liver Biopsy Specimens in Patients with Heroin Abuse and Coinfection (Tuberculosis, HCV, HIV) 235 Ivan B. Tokin, Ivan I. Tokin and Galina F. Filimonova Chapter 12 Future Aspects of Liver Biopsy: From Reality to Mathematical Basis of Virtual Microscopy 257 Ludmila Viksna, Ilze Strumfa, Boriss Strumfs, Valda Zalcmane, Andrejs Ivanovs and Valentina Sondore Chapter 13 Real-Time Tissue Elastography and Transient Elastography for Evaluation of Hepatic Fibrosis 281 Hiroyasu Morikawa ContentsVI Preface Liver biopsy is a procedure that involves obtaining a small piece of liver tissue, which is then analyzed in the laboratory. Liver biopsy may be used to evaluate a mass seen on ultrasound, CT or MRI images, diagnose unexplained liver diseases or abnormal liver function tests, determine the severity of the liver diseases including non-alcoholic liver disease, certain liver disease such as chronic hepatitis B or C, primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis, hemochromatosis or Wilson’s disease, and monitor the liver after a liver transplantation. Liver biopsy is a safe procedure when performed by an experienced doctor. However, it is an invasive procedure, and the common problems include mild pain and a decrease in blood pressure. Although more serious complications such as bleeding, infection, and injury of nearby organs are rare but potentially lethal, the monitoring within 24 hours after the liver biopsy is important. This book describes the role, indication, contraindication, technique and evaluation of outcome of liver biopsy. I believe that it will be greatly useful to the readers. Furthermore, this book introduces transgastric liver biopsy using NOTES technique and non-invasive alternatives including elastography and computer analysis of liver fibrosis as new tools for the evaluation of liver diseases. Nobumi Tagaya, M.D., Ph.D. Department of Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan Section 1 An Overview and Future Aspects of Liver Biopsy [...]... Carey WD Ultrasound-guided liver biopsy for parenchymal liver disease: an economic analysis Dig Dis Sci 1998;43:4 6-5 0 [40] Pasha T, Gabriel S, Therneau T, et al Cost-effectiveness of ultrasound-guided liver biopsy Hepatology 1998;27:122 0-1 226 [41] Kalambokis G, Manousou P, Vibhakorn S, et al Transjugular liver biopsy - indica‐ tions, adequacy, quality of specimens, and complications - a systematic review... Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease J Hepatol.2003;39:23 9-2 44 [73] Rocken C, Meier H, Klauck S, et al Large-needle biopsy versus thin-needle biopsy in diagnostic pathology of liver diseases Liver 2001;21:39 1-3 97 [74] Siddique I, El-Naga HA, Madda JP, et al Sampling variability on percutaneous liver biopsy in... with known liver disease Diagnosis •Identification and staging of parenchymalandcholestatic liver diseases -alcoholic liver disease -non-alcoholic steatohepatitis -autoimmune hepatitis -primary biliary cirrhosis -primary sclerosing cholangitis -metabolic and mitochondrial storage liver diseases such as Wilson’s disease, hemochromatosis, Gaucher’s disease •Evaluation of persistent abnormal liver biochemical... 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Guidelines: management of cholestatic liver diseases J Hepatol 2009;51(2):23 7-6 7 [16] European Association for Study of Liver EASL Clinical Practice Guidelines: Wilson’s disease J Hepatol 2012;56(3):67 1-8 5 [17] Pratt DS, Kaplan MM Evaluation of abnormal liver- enzyme results in asymptomatic patients N Engl J Med 2000;342:126 6-7 1 [18] Bianchi L: Liver biopsy in elevated liver function tests? An old question... Neuberger J: Guidelines on the use of liver biopsy in clinical practice Gut 1999;45(Suppl IV):IV1-IV11 [29] Sato S, Mishiro T, Miyake T, et al Prophylactic administration of antibiotics unneces‐ sary following ultrasound-guided biopsy and ablation therapy for liver tumors: Open-labeled randomized prospective study Hepatol Res 2009;39(1):4 0-6 [30] Hegarty JE, Williams R Liver biopsy: techniques, clinical applications, . LIVER BIOPSY - INDICATIONS, PROCEDURES, RESULTS Edited by Nobumi Tagaya Liver Biopsy - Indications, Procedures, Results http://dx.doi.org/10.5772/46113 Edited. from orders@intechopen.com Liver Biopsy - Indications, Procedures, Results, Edited by Nobumi Tagaya p. cm. ISBN 97 8-9 5 3-5 1-0 85 3-5 free online editions of